Exploring best practices and evaluating outcomes in community-based abortion care outside the formal health care system in the United States

Sarah Prager, University of Washington

Project abstract

Abortion restrictions and subsequent publicity on self-induced abortion have increased in the United States, raising safety concerns about these clandestine and stigmatized abortion practices. Meanwhile, anecdotal evidence from underground abortion providers outside the formal healthcare system suggests that they are administering safe and effective abortions. No in-depth studies have been published on the scope, services, and outcomes related to these “community-based abortion providers” in this country.

In partnership with the Community PI, this study will use community-based participatory research to engage community-based abortion providers in exploring their abortion care practices, and collect novel primary data on these under-researched methods and abortion access pathways. Researchers will work collaboratively with these Community Partners to: 1) identify community strengths, needs, gaps in knowledge, and best practices related to quality care; 2) develop research questions and data collection tools; 3) collect and analyze data on client-reported methods, health, safety, and pregnancy outcomes; and 4) create mutually beneficial products, tools, and publications for community-based abortion providers, their clients, and researchers.

The project will be implemented through in-person focus groups, electronic surveys, and webinars via a secure online collaborative workspace. Community Partners will be trained in data collection, and collaborate on creating resources related to their work, effectively building capacity among community-based abortion providers to preserve and expand their knowledge and skills. This unprecedented project will lay the groundwork for continued collaboration with community-based abortion providers, and make innovative contributions to inform the broader movement for advancing access to safe abortion care outside clinical settings.